Recreational Drugs, Alcohol, and Stroke

Man enjoying a drink at the bar
Yagi Studio/Digital Vision/Getty Images

Recreational Drugs, Alcohol, and Stroke

Years of research now show that drug use is a significant risk factors for stroke. Some drugs can cause stroke by directly affecting blood vessels in the brain while others cause stroke indirectly by affecting other organs in the body such as the heart, the kidneys or the liver. Common drugs of abuse that are known to increase the risk of strokes include the following:

Alcohol: Although alcohol in moderate amounts can protect you from having a stroke, there is no doubt that excessive intake can increase your risk of having a stroke. In fact, there is very specific information about how alcohol can cause a stroke and how many drinks of alcohol causes a stroke. Chronic excessive alcohol intake can precipitate all types of stroke, and most notably sharply raises the risk of hemorrhagic stroke. This is, in many cases, the result of harmful effects of alcohol on the liver, as this organ makes proteins which are necessary to prevent spontaneous bleeding. However, most of the risk of stroke with excess alcohol intake appears to be due to a combination of high blood pressure, and impaired blood clotting mechanisms.

Cocaine: There is a clear association between cocaine use and stroke. Cocaine use can cause a sudden stroke during or shortly after using the drug. Additionally, long term repeated use of cocaine can also cause cerebrovascular disease over time, significantly increasing the risk of stroke, even in otherwise healthy young people who do not have any other risk factors of stroke.

The most important ways by which cocaine use increases the risk of stroke include the following:

  • By dramatically and quickly increasing blood pressure and causing bleeding in the brain
  • By causing narrowing of blood vessels in the brain with chronic, long term use
  • If used in its intravenous form known as crack cocaine increases the risk of serious infections in the heart valves, or endocarditis, a condition that can lead to embolic stroke

    Heroin: Heroin is an addictive drug that is commonly abused in the United States. Similar to intravenous cocaine, intravenous heroin also increases the risk of endocarditis, a condition in which bacteria enter the blood and grow over the valves of the heart. Small pellets of these bacteria, known as septic emboli, may leave the heart, head towards the brain and block a blood vessel in the brain, causing a stroke. Because heroin is injected, its use also increases the risk of diseases transmittable by the sharing of needles such as HIV and hepatitis C.

    Amphetamines: There have been many reports of amphetamine use in the hours before suffering a major stroke. Amphetamines such as methamphetamine appear have a powerful ability to cause extreme levels of high blood pressure. As high blood pressure is the number one risk factor for stroke, it is not surprising that amphetamine use can increase a person's risk for stroke. As with cocaine, long term use of methamphetamine increases stroke risk by causing abnormal functioning in the blood vessels of the brain, while harming the rest of the body.

    Short term use of methamphetamine may result in a sudden stroke during or after use, largely as a result of sudden changes in blood pressure and heart function induced by methamphetamine in the body.

    Other drugs which have been linked to ischemic, hemorrhagic or hypertensive strokes include:

    J. P. Mohr, Dennis W. Choi, James C. Grotta, Bryce Weir, Phillip A. Wolf Stroke: Pathophysiology, Diagnosis, and Management Churchill Livingstone; 4th edition (2004).
    Treadwell SD, Robinson TG Cocaine use and stroke Postgrad Med J. Jun; 83:389-94 2007.
    Hiroyasu Iso, MD; Shunroku Baba, MD; Toshifumi Mannami, MD; Satoshi Sasaki, MD; Katsutoshi Okada, MD; Masamitsu Konishi, MD Shoichiro Tsugane, MD for the JPHC Study Group Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I Stroke 2004;35:1124

    Other Causes of Stroke
    What Are The Symptoms of a Stroke?

    How Can I Lower My Risk of Stroke?

    Continue Reading